Methodical approaches to assessing public health risks under combined exposure to climatic factors and chemical air pollution caused by them

The ongoing climate change makes its contribution to public health risks. These risks can be caused both due to direct impacts of the process and modifying influence exerted by climatic factors on chemical levels in ambient air. Given that, it is advisable to develop methodical approaches that give an opportunity to quantify public health risks under combined influence of climatic factors and chemical air pollution caused by them. In this study, we suggest methodical approaches eligible for calculating, assigning a category and assessing acceptability of public health risks under climatic exposures considering their influence on chemical air pollution. We outline approaches to establishing priority climatic factors, calculating exposure levels and associated responses; making up a list of chemicals levels of which are influenced by climatic factors and probable health outcomes caused by exposure to them; identifying levels of chemicals associated with climatic influence; calculating and assigning a category for public health risks associated with combined exposure to climatic and chemical factors using a multiple logistic regression model. We tested the approaches using data collected in Perm in 2020. As a result, we established an unacceptable health risk for working age population (1.11·10-4) due to cerebrovascular diseases (I60-I69). This risk was associated with combined exposure to climatic factors (heat waves) and associated chemical air pollution (high levels of carbon oxide). Risk levels for working age population and older age groups due to diseases of the circulatory system (ischaemic heart diseases (I20-I25) and other cardiac arrhythmias (I49)) were rated as permissible (acceptable), 7.68·10-5 and 4.07·10-5 accordingly. The contribution made by the analyzed climatic factor (heat waves) varied between 76.24 and 92.44 %; the analyzed chemical factor (carbon oxide), between 7.56 and 23.76 %.